P18 AORTIC STIFFNESS IN AORTIC STENOSIS: SHORT TERM HEMODYNAMIC CHANGES AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION

Abstract

Background: Both aortic valve stenosis as aortic stiffness are moderators of arterio-ventricular coupling and independent predictors of cardiovascular morbidity and mortality. Studies on the effect of Transcatheter Aortic Valve Implantation (TAVI) on hemodynamic parameters are limited. We performed a pilot study to investigate possible short-term hemodynamic changes after TAVI in older patients. Methods: TAVI Care & Cure is an observational ongoing study including consecutive patients undergoing TAVI procedure. Central and peripheral hemodynamic measurements were measured non-invasively 1 day before (T0) and 1 day after (T1) TAVI using a validated oscillometric method using a brachial cuff (Mobil-O-Graph). Results: 40 patients were included. Mean aortic valve area at baseline was 0.73 ± 0.18 cm2. As expected indices of severity of the aortic valve stenosis improved. Systolic blood pressure (SBP) dropped by 8.5%, from 130.3 ± 22.9 mmHg to 119.5 ± 15.8 mmHg (p = 0.005). Diastolic blood pressure (DBP) dropped by 13.1 % from 74.8 ± 14.5 mmHg to 65.0 ± 11.3 mmHg (p < 0.001). The aPulse Wave Velocity (aPWV) decreased from 12.05 ± 1.99 m/s to 11.6 ± 1.56 m/s (p = 0.006)(Fig. 1). Patients with high aPWV at baseline showed a significantly larger reduction in SBP in comparison to patients with low aPWV: − 20.3 mmHg (−14,1%) vs – 3,1 mmHg (−2.6%), respectively (p = 0.033). The same trend was found for the DBP: −16.2 (−20.4%) v.s. −4.5 mmHg (−6.3%) for high vs. low aPWV at baseline (p=0.037). Conclusion: We found short term changes of blood pressure and aortic stiffness after TAVI. The amplitude of the changes was the largest in patients with elevated aortic stiffness at baseline.